A profession under pressure

In March 2024 the RCSLT was commissioned by NHS England to undertake a project to explore the workforce implications of waiting lists in children and young people’s speech and language therapy services. As part of the project, the RCSLT conducted a survey of speech and language therapists (SLTs) across the UK, to gather information about the factors that were influencing SLTs to stay in or leave their roles.

1,168 speech and language therapists completed the survey between September and October 2024, evidencing both the significant level of interest in this issue and the desire for change. The results provide an overview of the experiences of SLTs across the four UK nations.

Some of the key findings include:

• 61% of SLTs reported that they often or always experience unrealistic time pressures at work. This figure rises to 68% for SLTs working in the NHS;
• More than half (55%) of the SLTs reported experiencing burnout in the 12 months prior to completing the survey. Workload pressures, caseload complexity and insufficient staffing levels were cited as significant contributing factors;
• Achieving a good work-life balance was a significant concern for many SLTs, with 33% citing this as a factor that was somewhat or strongly influencing them to leave the profession.
• 42% of SLTs said that they needed to use their own time to complete the continuing professional development (CPD) required in order to remain clinically safe. While more than a quarter (28%) of respondents did not think there were opportunities to develop their career within their current organisation.

Those SLTs who work with children and young people were asked some additional questions to explore the workforce implications of waiting times.

• 71% of NHS SLTs were concerned about the wait that children, young people and their families experience for a first appointment, rising to 81% of NHS SLTs concerned about waits for further support and intervention after the first appointment. SLTs who were concerned about waiting times within their services were more likely to report experiencing burnout.
• Only 40% of SLTs reported that their service was always or usually able to provide the speech and language therapy that children and young people need. This was even lower at 33% for NHS SLTs.
• The main barriers that services experience in providing therapy for children and young people were reported as: not having enough staff (79%), time constraints (75%) and funding (58%).

A summary of all the key findings is available to read alongside the full report. Full survey data is also provided.

The survey was part of the RCSLT’s wider workforce, education and training programme which was designed to look at the ongoing educational priorities and career development routes for SLTs with a long-term goal of improving retention.

However, real change is urgently needed to support the speech and language therapy workforce. Governments across the UK need to take action to ensure that stakeholders, commissioners, decision-makers and providers work together with SLTs and service users to design and adequately resource speech and language therapy services that are safe, fit for purpose and clinically effective.

RCSLT recommendations

In particular we recommend that:

• Service provision, caseload sizes and time pressures should be reviewed by services, and any concerns escalated to those who plan and fund services.
• Workforce planning needs to recognise the importance of the retention and wellbeing of therapists already delivering services, as well as the need for the ongoing development of routes into the profession.
• The importance of access to CPD opportunities for safe and effective practice should be explicitly recognised and time should be built into workloads to accommodate this.